Medicare Care Choices Model Update

The Medicare Care Choices Model announced during the CMS Open Door Forum on Wednesday February 8 that four restrictive enrollment requirements have been relaxed.  They include:

  1. April 2016
    1. 2 hospitalizations, reduced to 1 encounter of any kind, including ED, observation or inpatient admission
    2. No participation in Part D, but provider gathers information on drug coverage
  2. January 1, 2017
    1. Reduced 24 months to 12 months of Medicare enrollment to include both Medicare A and Medicare B as the primary insurance.
    2. 3 office visits for eligible diagnosis reduced  to 3 office visits , for any Medicare enrolled physician for any diagnosis.

NHPCO has worked closed with the CMS MCCM staff on eligibility concerns, is pleased with the two additional enrollment changes and will continue the dialogue with CMS to identify additional enrollment barriers and encourage success for both Cohort 1 and for the hospice awardees in Cohort 2, with start up on January 1, 2018.